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NACCHO Statement on Report by Trust for America’s Health: “Ready or Not Protecting the Public’s Health from Disease, Disaster, and Bioterrorism”

Washington, DC (December 15, 2009)— The report card on state readiness to respond to public health emergencies, issued today by Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation, sounds a warning. Serious underlying gaps have been exposed in the nation's ability to respond to public health emergencies. The economic crisis is straining an already fragile public health system.

"In these especially challenging times of recession and epidemic, particularly those associated with this year's influenza season, local health departments across the country are playing a vital role in protecting the public's health." said Robert M. Pestronk, executive director of NACCHO. "Their dedication and resourcefulness has been exemplary. But their capacity is severely strained. Additional financial resources are needed to ensure the conditions that promote health and equity, combat disease, and improve the quality and length of all lives."

Earlier this year, NACCHO surveyed a sample of local health departments (LHDs) nationwide to measure the impact of current economic conditions on LHDs' budgets, workforce, and programs. The report, released last month, showed that LHDs—the local stewards of public health—have begun to eliminate or reduce vital programs and staff. In the first half of 2009, approximately 8,000 staff positions in LHDs were lost due to layoffs or attrition. An additional 12,000 LHD employees were subjected to reduced hours or mandatory furloughs.

The nation's local health departments serve on the front lines of public health emergency response. They detect and stop outbreaks of disease and distribute and administer vaccines. Budget cuts and layoffs make it difficult for health departments to keep communities safe and prepared for inevitable public health crises. Preparedness is an ongoing commitment and local health departments need consistent, sustained funding to ensure continuous improvement.

The first response to any public health emergency is a local one. Readiness requires continued training and exercising in both real events and drills and the staff to engage community partners in both the private and public sectors. NACCHO shares TFAH's concern that the federal failure to sustain public health preparedness funding has jeopardized response.

NACCHO commends TFAH for compiling this useful information on public health emergency readiness and urges Congress and the Administration to recognize that sustained federal funding is essential to prepare the nation for public health emergencies such as the H1N1 flu outbreak. Upcoming health reform legislation presents an opportunity both to save jobs and protect the public's health. The Prevention and Public Health Fund would assure funding for local health departments to help meet the increasing demands for services that the public desires. Adequately funded and working together, federal, state, and local government can make good health the default option for everyone.

The National Association of County and City Health Officials (NACCHO) represents the nation's 2800 local governmental public health departments. These city, county, metropolitan, district and tribal departments work every day to protect and promote health and well-being for all people in their communities.